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JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 401k Plan overview

Plan NameJOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN
Plan identification number 503

JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

FURLANI FOODS LLC has sponsored the creation of one or more 401k plans.

Company Name:FURLANI FOODS LLC
Employer identification number (EIN):391022079
NAIC Classification:311800
NAIC Description: Bakeries and Tortilla Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-06-01
5032018-06-01
5032017-06-01DONALD HARLING DONALD HARLING2018-12-31
5032016-06-01DONALD HARLING JR. DONALD HARLING JR.2017-11-29
5032015-06-01DONALD HARLING JR. DONALD HARLING JR.2017-11-29
5032014-06-01DONALD HARLING JR. DONALD HARLING JR.2017-11-29
5032013-06-01DONALD HARLING JR. DONALD HARLING JR.2017-11-29

Plan Statistics for JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN

401k plan membership statisitcs for JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN

Measure Date Value
2019: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01149
Total number of active participants reported on line 7a of the Form 55002019-06-01168
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01168
Total participants2019-06-01168
Number of employers contributing to the scheme2019-06-010
2018: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01136
Total number of active participants reported on line 7a of the Form 55002018-06-01149
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-06-010
Total participants2018-06-01149
Number of participants with account balances2018-06-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-06-010
Number of employers contributing to the scheme2018-06-010
2017: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01153
Total number of active participants reported on line 7a of the Form 55002017-06-01136
Number of retired or separated participants receiving benefits2017-06-011
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-06-010
Total participants2017-06-01137
Number of participants with account balances2017-06-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-06-010
Number of employers contributing to the scheme2017-06-010
2016: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01143
Total number of active participants reported on line 7a of the Form 55002016-06-01153
Number of retired or separated participants receiving benefits2016-06-011
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-01154
2015: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01126
Total number of active participants reported on line 7a of the Form 55002015-06-01142
Number of retired or separated participants receiving benefits2015-06-011
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01143
2014: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01123
Total number of active participants reported on line 7a of the Form 55002014-06-01126
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-01126
2013: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01101
Total number of active participants reported on line 7a of the Form 55002013-06-01123
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-01123

Form 5500 Responses for JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN

2019: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Submission has been amendedNo
2017-06-01This submission is the final filingNo
2017-06-01This return/report is a short plan year return/report (less than 12 months)No
2017-06-01Plan is a collectively bargained planNo
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: JOSEPH CAMPIONE, INC. GROUP DENTAL INSURANCE PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01First time form 5500 has been submittedYes
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number1341000000
Policy instance 1
Insurance contract or identification number1341000000
Number of Individuals Covered168
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,476
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,476
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number1341000000
Policy instance 1
Insurance contract or identification number1341000000
Number of Individuals Covered149
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $4,495
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,495
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number13410 00000
Policy instance 1
Insurance contract or identification number13410 00000
Number of Individuals Covered136
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $4,430
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,430
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameR&R INSRUANCE

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